Healthcare Provider Details

I. General information

NPI: 1962354548
Provider Name (Legal Business Name): VITALITY ACUPUNCTURE, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8920 WILSHIRE BLVD STE 610
BEVERLY HILLS CA
90211-2006
US

IV. Provider business mailing address

11736 CANTON PL
STUDIO CITY CA
91604-4165
US

V. Phone/Fax

Practice location:
  • Phone: 319-926-4408
  • Fax:
Mailing address:
  • Phone: 310-562-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN KRISCHER
Title or Position: CEO
Credential:
Phone: 310-562-8471